LEAD Pivots to Focus on Jail Releases, King County Outlines Behavioral Health Strategy for COVID Isolation Sites

Partitions between beds at the county’s COVID-19 isolation and recovery site in Shoreline.

1. The Public Defender Association’s Law Enforcement Assisted Diversion program, which in normal times is a program that keeps low-level offenders out of jail by providing case management and connections to services, has pivoted during the COVID epidemic to focus on people who are being let out of King County jails to prevent overcrowding and who have few social supports or legal sources of income. The Co-LEAD Program, PDA director Lisa Daugaard says, is “starting with people who were released in the wave of jail releases and are not doing very well, which is, of course, totally predictable.” The program is also accepting referrals from prosecutors, defense attorneys, and law enforcement—”people who in normal days might be subject to arrest but that is completely off the table,” Daugaard said.

With job opportunities virtually nonexistent (and work release shut down for the foreseeable future), Daugaard says property crime has risen in some areas. “For a lot of people without any means of support, what’s the option?” she says. “There’s got to be some strategy for people to take care of their basic needs when there is no way to earn money. That is the bottom line for a lot of folks.”

The Co-LEAD program, which launched this week in Burien, is providing former jail inmates with access to hotel rooms, gift cards, and crisis intervention. So far, the PDA has reserved about 25 rooms in hotels along the I-5 corridor and “we plan on scaling that up rapidly.”

If you’re wondering where LEAD is getting the money to do all this—wasn’t the mayor still withholding their 2020 funding and refusing to sign a contract until LEAD met a long list of conditions?—the answer is that the city finally signed the contract and released LEAD’s full 2020 funding in late March, after the COVID epidemic hit. “We finally executed the contract for the total amount of funding and immediately the world is different,” Daugaard says.

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2. King County is opening hundreds of hotel rooms and field hospital beds for shelter residents and for those in isolation or quarantine who have (or may have) COVID-19 and have no safe place to isolate or recover. One question that has come up both tacitly and explicitly, in Seattle and in other cities with large homeless populations, is what happens when someone needs crisis intervention or help managing their active addiction.

Both Seattle mayor Jenny Durkan and San Francisco Mayor London Breed have suggested that it would be prohibitively expensive, for example, for cities to rent out large blocks of hotel rooms for people experiencing homelessness, because they would have to be heavily staffed by care workers—workers who would need to be trained, it is implied, to intervene at a moment’s notice when homeless clients act out, attempt to destroy hotel property, or try to leave.

“It’s a scary, isolating, confusing, lengthy process, so everybody who we’ve put in these rooms has needed behavioral health care at one time or another. On day 7, after you’ve been in a hotel for that long, just human contact is important.”—King County Behavioral Health and Recovery Division director Kelli Nomura

Kelli Nomura, the director of King County’s Behavioral Health and Recovery Division, says the county has not had to ask anyone to leave any of its quarantine, isolation, and recovery centers, which, as of Sunday, will include a 140-bed field hospital in Shoreline. The county is connecting people to their existing providers when they have them, and providing behavioral health and addiction management services through its King County Integrated Care Network if they don’t.

“Everyone who’s going into these facilities is needing some level of behavioral health support,” including people who aren’t homeless, Nomura says. “It’s a scary, isolating, confusing, lengthy process, so everybody who we’ve put in these rooms has needed behavioral health care at one time or another. On day 7, after you’ve been in a hotel for that long, just human contact is important.”

Nomura says there have been instances when someone with a severe, persistent mental health disorder has had an acute episode, or when people who are actively using drugs or drinking have needed immediate help managing withdrawal symptoms. When that happens, she says, behavioral health staff either connect them by phone with their existing provider or “just step in and do that crisis intervention ourselves. … We have been deescalating, doing motivational interviewing, and you might have to go into on site” to go into a person’s room and intervene, she says.

The county is reserving beds at its isolation and quarantine site on Aurora Ave. N, which includes 23 units in modular buildings, for people who need daily methadone dosing, Nomura says, but opiate users who take Suboxone (buprenorphine) to manage their addictions can fill their prescriptions or get a new one at the other sites.

As of tomorrow, the county will have opened just over 400 units in isolation, quarantine, and recovery sites, including the 140 beds opening in Shoreline on Sunday. Department of Community and Human Services spokeswoman Sherry Hamilton says additional sites at Eastgate in Bellevue and in White Center will be ready later this month; an additional site in Seattle’s Interbay neighborhood, which was initially planned as an isolation and quarantine location, may instead be used as an expansion site for the city’s still-overcrowded shelters.

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